1. Stroke Module Scene B – CT Scan

2. Scene B Introduction Mr. Jones has been prepped and readied for his CT scan to see if his headache is being caused by bleeding in the brain. Please proceed to the CT scan room to begin this test.

3. Scene B 1 – CT Scan Protocol EMREMR Dr.’s Notes Patient History Protocol: 1. Adjust height of gurney so the bottom of the gurney is level with the inner CT circle.

4. Scene B 2 – CT Scan Protocol EMREMR Dr.’s Notes Patient History Protocol: 2. Adjust the patient’s gurney forward until the base of the patient’s skull is on the far side of the inner CT circle.

5. Scene B 3 – CT Scan Protocol EMREMR Dr.’s Notes Patient History Protocol: 3. Go into the CT control room.

6. Dr.’s Notes Patient History Scene B4 Scan Options: Circle of Willis Scan Parameters Routine Head Scan Parameters Sinus Supine Scan Parameters 4. Select the “Routine Head Scan Parameters” option. EMREMR Protocol

7. Dr.’s Notes Patient History Scene B5 5. Run the CT scan EMREMR Protocol Run Scan

8. Dr.’s Notes Patient History Scene B 6 6. Locate the suspected bleed on the CT scan results EMREMR Protocol CT Scan Results

9. Dr.’s Notes Patient History Scene B 6 7. Order your next diagnostic test. EMREMR Protocol CT Scan Results Diagnostic Test Options: MRI Scan PET Scan CT Angiogram Subarachnoid Hemorrhage

10. Scene B Conclusion Dr. _______, Great job! Mr. Jones is certainly benefiting from your expertise and hard work. Mr. Jones will be waiting for you in the CT angiogram room.

11. Cat Scan Results The bright white areas in the brain indicate bone and blood. The grey areas are brain tissue. As you can see in this scan, there is bleeding in Mr. Jones’ brain. This is known as a hemorrhagic stroke. Given the location, this would be classified as a subarachnoid hemorrhagic stroke (SAH stroke). SAH strokes are normally caused by either trauma to the head or an aneurysm. Since there is record of trauma in Mr. Jones’ patient history, you need to run another diagnostic test to see if there is an aneurysm. BleedingBone

12. Dr. _______’s Notes (Scene B) Subarachnoid hemorrhagic (SAH) stroke diagnosed SAH stroke is probably due to an aneurysm since there is no trauma in Mr. Jones’ recent patient history CT angiogram ordered to located suspected aneurysm Return to ER Bleeding